Baby Care After Circumcision

Post Circumcision Concerns and Questions

We understand that parents will sometimes have concerns and questions in the days after a baby boy’s circumcision.

Please see the detail below for information on how to care for your baby post-circumcision, and do not hesitate to contact us with any concerns that you feel require the doctor’s attention.

If you have not already done so, please see our Parent Counselling Video before the procedure.

The video describes how to prepare for the circumcision, what to expect at the clinic, and includes our aftercare instructions.

Our staff is always available to answer your questions.

We will review aftercare instructions with you as well.

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In the 24 Hours After Circumcision

1 - Keep your son snugly swaddled (especially his legs). The more he kicks his legs, the less comfortable he may be. After 24 hours, you no longer need to swaddle him unless he finds comfort in doing so.
2 - There will be a square white gauze with Vaseline placed over the head of your son’s penis. Leave the gauze in place and remove it after 24 hours. If it has fallen off, not to worry- just replace it with a fresh 3×3 gauze with some Vaseline on it and put it over the penis then close the diaper.
3 - There will also be a long white (and a brown bandage) wrapped around your son’s penis. Leave this gauze in place then remove it after 24 hours as well. If it falls off earlier, don’t worry just leave this one off. If it is dry or stuck when you are trying to remove it after 24 hours, you may need to pull slightly harder and there may be a little bleeding when you do this. This is normal and you may need to apply some direct pressure on the head of the penis as we taught you in the clinic. You may use some warm water to wet the dressing to help remove it. If there is some bleeding, maintain firm pressure for 5 minutes.
4 - Please check your son’s diaper every hour for the next 24 hours to look for any abnormal bleeding.
5 - If the white gauze is soiled with urine or stool don’t worry just leave it alone. You may rinse his bum with warm water or use wipes on the bum, just not the penis.
6 - No gauze or bandages are required after the first 24 hours, just generous amounts of Vaseline to be applied every diaper change to the penis or front part of the diaper.
7 - It is normal for your son to be a little irritable or very sleepy for the first 24 hours following the circumcision.
8 - Maintain two diapers for extra padding for the next 4 days.
Circumcision baby care Vancouver
– Here you see the square white gauze with Vaseline that you will replace for the first 24 hours if it falls off. You also see long white gauze and bandage around it that will be removed in 24 hours or if it falls off earlier you may leave it off.

We offer 24/7 aftercare and support.

General Care in the Weeks Following Circumcision

1 - Healing is promoted by keeping the area clean and dry. Use disposable diapers for the first week; they are less irritating and help keep the area drier and cleaner.
2 - Do not bathe your son for the first 4 days. You may sponge bathe the rest of your son’s body in the meantime. You may also gently clean the area around the penis with warm water and a soft washcloth. Do NOT use baby wipes, towelettes, alcohol, powders or lotion as these may cause irritation.
3 - Often skin glue will be applied to reduce the incidence of bleeding. When the bandage is removed this often appears like “extra skin” or “dried Vaseline” or a “hardened piece of gauze”. Please do not try to peel the glue off as it will dissolve on its own once you start bathing your son again.
4 - Avoid unnecessary car travel as car seats can be irritating to a newly circumcised penis. If you are using a car seat, a folded diaper placed between your baby and the car seat straps will help prevent pressure on the penis.
5 - For the first 2 weeks after circumcision, put a generous amount of Vaseline on your finger and rub it over the incision site or front part of the diaper facing his penis, placing a thick layer of ointment over the entire head of the penis at every diaper change.
6 - After 4 days it is important to push the skin down off the head of the penis if it has moved up a little, to ensure it heals properly just behind the back rim of the head. Simply ensure you can see the entire head of the penis all the way around; if you are unsure you may see us in the clinic or send a photo to the doctor. Do not do any pushing on the skin during the first 4 days because it will be swollen from the surgery. It is important to avoid “skin bridging” which results from the shaft skin attaching to the head of the penis. Again, if you are unsure of the appearance of your son’s penis, call the clinic, and the doctor will adjust the skin for you if required.
7 - Most babies like to feed in a quiet environment following the circumcision. If your baby cries for more than a few minutes, it could be from air swallowed during the circumcision, and he will need to be burped.
8 - If fever is noticed, you may give him 1 ml of Tempra or Infant Tylenol.
Circumcision in BC Canada
– Here you see a part of the mucosa attaching to the head of the penis. This is an example of “bridging” that requires a simple adjustment by our doctors.

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The Healing Process After Circumcision

Healing is usually rapid and occurs in several stages. Remember that a circumcision is like any other cut. There are many factors that influence healing; but most importantly, every child heals differently.

First, the cut edge seals and bleeding ceases within minutes, hours, or even over the course of an entire day. The area just behind the glans (especially the underside) will become swollen. Sometimes parents mistake this for a blister. In fact, this is NORMAL and will subside within a week or two.

In the first two days, there may be an off-white or yellowish, patchy appearance or discoloration of the glans. These patches are a type of scab and are associated with normal healing. After a few days the area where the skin was cut may look green and yellow. This is NOT pus or infection. It is part of the normal healing process and it can took this color for up to two weeks after the circumcision. Some physicians are not familiar with this healing process and may mistake this for infection. Please follow up with our doctors if you are concerned.

You will also notice that the glans appears red and glossy sometimes purple or blue. This is because the skin covering the glans of an uncircumcised penis is mucous membrane (like the skin inside your cheek). Once exposed, the mucous membrane will toughen (or keratinize), and, in time, take on a normal appearance. It takes about a month for the penis to take on a normal, healed appearance.

The Appearance of the Penis During Healing

A common concern for parents is aesthetics. Remember that penises come in all shapes and sizes. While most penises “look normal” within days of the circumcision, some do not take on a “completely normal appearance” until after the penis starts to grow after many years. For example, there may be more mucosal tissue on one side compared to the other; this is a normal anatomical variation after circumcision that will resolve with time after your son grows older.

Furthermore, although the penis may appear smaller after circumcision, it is not. This appearance is mostly due to the foreskin giving the appearance of a larger penis prior to circumcision. In nearly all these cases, the penis will heal properly, and in time, take on a normal appearance. If you are concerned in any way about the appearance of your son’s penis, please call to consult us.

Sometimes parents come to us worried about a band on the bottom of the penis fearing that it needs to be cut. This band is called the frenulum which carries the frenular artery and is normal.

It is similar to the band under the tongue (the part that is cut in some babies with tongue-tie). It is rare that an infant frenulum would present any issues requiring our intervention.

As always, please ask us your questions, but do not be unduly concerned. If in doubt, have us check your son’s penis to ensure proper healing, and it will almost certainly be fine.

Common Concerns From Parents After Circumcision

It is not unusual for your son to sleep 6-8 hours after the procedure and to miss a feeding or meal. Some patients will be irritable for a number of minutes to hours afterwards. Behaviorally, most babies and children are back to themselves by the next day or two.

In general, complete healing occurs in about four weeks but most newborns or children show signs of healing by 1 week.

It may sting a little on the first day, but after a day it should not be painful.

It is normal to use some force to pull off the gauze bandage. To make this easier, you can soak the gauze with warm water and Vaseline before pulling it off. In the end, you just may have to pull a little more firmly to get it off. Remember the direct pressure technique if you notice any bleeding. You can also wait until day 4 when you bathe him. The dressing comes off easily then. You can also come to the clinic for assistance if you are having difficulty.

A small amount of bleeding is normal. Take some gauze with Vaseline on it and squeeze the bleeding area of the penis with your fingers for 3-5 minutes.

This is not important. You may leave it off. Reapply a white gauze pad with Vaseline and place it over the penis until the 24 hours is up. Then, just use Vaseline as instructed at the incision site on every diaper change.

Not to worry just try to clean the area as best you can using warm water and a cloth. Then place the white gauze with Vaseline on until the 24 hour mark is achieved.

If you are concerned about skin bridging, come back to have the baby examined. Usually it is very easy for us to make an adjustment.

For newborns, our physicians will let you know when at your follow up when you can start immersing your son in water. Generally, it is after 4 days.

Apply a generous amount of Vaseline over the incision and the entire penis head with each diaper change. This is done for 2 weeks.

When there is a good amount of pubic fat or when the penile shaft is no greater than its diameter, the penis may tend to retract inward. This is normal. If your son fits this profile you can reduce the chance of a concealed penis by applying Vaseline to the entire glans once a day until the glans takes on a healed appearance (up to 6 months). To expose the glans that has retracted inwards, place gentle downward pressure on either side of the penis and consult one of our doctors if the head
cannot be fully exposed. This may take months up to a few years before the penis stays persistently outward.

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